Fiducial Placement and Pleural Dye Marking wtih ENB

http://www.youtube.com/watch?v=0YbZDYR1zl4&feature=related

STEREOTACTIC RADIOTHERAPY

WITH REAL-TIME TUMOR TRACKING

FOR NON-SMALL CELL LUNG

CANCER: CLINICAL OUTCOME

 

NC van der Voort van Zyp, J-B Prevost, MS Hoogeman,

J Praag, B van der Holt, PC Levendag, RJ van Klaveren,

P Pattynama, JJ Nuyttens




Purpose

To report the clinical outcome of treatment using real-time tumor tracking for 70 patients

with inoperable stage I non-small cell lung cancer (NSCLC).

Methods

Seventy inoperable patients with peripherally located early stage NSCLC were treated with

45 or 60 Gy in 3 fractions using the CyberKnife. Pathology was available in 51% of patients.

Thirty-nine patients had a T1-tumor and thirty-one had a T2-tumor. Markers were placed

using the vascular, percutaneous intra-, or extra-pulmonary approach, depending on the risk

of pneumothorax.

Results

The actuarial 2-year local control rate for patients treated with 60 Gy was 96%, compared

to 78% for patients treated with a total dose of 45 Gy (p=0.197). All local recurrences (n=4)

occurred in patients with T2-tumors. Overall survival for the whole group at two years was

62% and the cause speci

fi c survival was 85%. The median follow-up was 15 months. Grade

3 toxicity occurred in two patients (3%) after marker placement. Treatment-related late grade

3 toxicity occurred in 7 patients (10%). No grade 4 or 5 toxicity occurred.

Conclusion

Excellent local control of 96% at 1- and 2-years was achieved using 60 Gy in 3 fractions for

NSCLC patients treated with the real-time tumor tracking. Toxicity was low.